What comes to mind when you hear “brain fog”? Prior to the emergence of COVID-19, the term was commonly associated with women’s health issues—especially those related to menopause, according to research published by Harvard Health.

Bilodeau K. Sleep, stress, or hormones? Brain fog during perimenopause. Harvard Health. April 9, 2021.

 

But a 2022 article published by the Journal of Health Service Psychology reported that about a third of patients who contract COVID-19 are left with an array of persisting symptoms, including brain fog.

​​Krishnan K, Lin Y, Prewitt KRM, et al. Multidisciplinary approach to brain fog and related persisting symptoms post COVID-19. J Health Serv Psychol. 2022;48(1):31–38.

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What is brain fog?

According to the Journal of Health Service Psychology, brain fog is associated with post-acute sequelae of COVID-19 and generally refers to cognitive impairments among those who experience it.

The Journal of Health Service Psychology article recounted the clinical vignette of Ella Smith, a patient who struggled with this condition as a result of COVID-19.

Smith is a 35-year-old critical care nurse who tested positive for COVID-19. Although hospitalized for 1 day, she did not require life support.

Smith’s symptoms, however—which initially included shortness of breath, cough, fever, fatigue, and difficulty sleeping—remained. On top of that, she struggled to stay attentive and recall information, which she described as brain fog.

While COVID-19 has been linked to this condition in patients like Smith, clinicians should keep in mind that COVID-19 is just one of many illnesses linked to it.

 

Mysteries of brain fog

To get a better look at the role nutrition plays in the management of brain fog, MDLinx spoke with Crystal M. Gossard, DCN, CNS, LDN, and team member of the wellness company Life Extension.

Between treating patients with thyroid issues, food sensitivities, fibromyalgia, seasonal allergies, and respiratory infections, Dr. Gossard is no stranger to brain fog. She said that chronic fatigue and chemotherapy treatments may also pave the way for this condition to take hold of patients.

According to Dr. Gossard, brain fog doesn’t have a definitive cause, but is rather associated with many illnesses. She described the condition as a collection of neurological symptoms. Reduced focus, memory impairment, and increased mental fatigue are just a few that could fall under the umbrella term.

In my world of nutrition—but more specifically functional nutrition (integrative medicine)—brain fog has always been something that we’ve talked about.

The question remains, then: How can doctors effectively treat it?

 

The role of nutrition

For Dr. Gossard, returning to nutritional basics is crucial to mitigating cognitive impairment associated with brain fog. The goal is to address neuroinflammation, which is associated with COVID-19-related complications.

First things first: Try to get inflammation down in your body. You have to look at foods that are pro-inflammatory and limit those.

For Dr. Gossard (who had COVID-19), that meant cutting out red meat due to its omega-6 content, as well as limiting eggs and dairy.

On top of cutting back on certain foods, Dr. Gossard recommended foods that may help patients strike a better overall nutritional balance.

“Adding in omega-3 fatty acids—which can offset the omega-6 fats—can bring you to a healthier ratio of omega-6 to -3,” she said. She also encouraged patients to make sure they’re taking vitamin B-complex and getting adequate protein, which provides patients with the amino acids needed to make serotonin, dopamine, and GABA.

In addition, certain herbal supplements have been shown to increase focus and memory function in individuals.

Standardized mangiferin (a product of mango leaf extract) was shown to improve attention as soon as 30 minutes after ingestion in a study published in 2020 by Nutrients.

Wightman EL, Jackson PA, Forster J, et al. Acute effects of a polyphenol-rich leaf extract of mangifera indica L. (Zynamite) on cognitive function in healthy adults: A double-blind, placebo-controlled crossover study. Nutrients. 2020;12(8):2194.

It can also improve working memory function, helping to convert short-term memories to long-term, according to research published in Saudi Journal of Biological Sciences.

Lum PT, Sekar M, Gan SH, et al. Protective effect of mangiferin on memory impairment: A systematic review. Saudi J Biol Sci. 2021;28(1):917–927.

 

Herbs containing menthol have also shown to provide cognitive benefits by targeting inflammation; Peppermint and spearmint are two examples. As reported in a 2018 Nutrients article, peppermint can help fend off mental fatigue, while spearmint can improve concentration.

Kennedy D, Okello E, Chazot P, et al. Volatile terpenes and brain function: investigation of the cognitive and mood effects of mentha × piperita l. Essential oil with in vitro properties relevant to central nervous system function. Nutrients. 2018;10(8):1029.

 

 

Other options may help

Dr. Gossard believes that relying on nutrition and supplements is an effective approach to managing brain fog—but she’s not writing off other forms of treatment.

There is definitely a role for prescription medication and pharmaceuticals. But I think the beauty with natural remedies is that we know what they’re doing but it’s more than just targeting that one little pathway.

“These nutrients can go in, and while we know that they may be helping to regulate a specific pathway, they are doing so many other great, nourishing roles in the body that can help the body to do its job,” Dr. Gossard said.